Chakravarthy K1, Anil Choppadandi2, Balakrishna Namala3, Mohammed Abdul Majeed4, Nageswari Devi5, Sridhar V. Maddikunta6 Madhavi Latha Kodru7, Souris Kondaveti8
BACKGROUND
Diabetic Retinopathy (DR) is the most common microvascular complication of Diabetes Mellitus (DM) and is the leading cause of blindness in working age adults of patients with type 1 and 2 DM. Large observational and randomised studies shown that optimal blood glucose and blood pressure control halt or regress the disease and limit the risk of progression to the proliferative stage and visual loss. Recently, evidence has also emerged that Renin-Angiotensin System (RAS) inhibitors may electively prevent or delay progression of retinopathy by acting on local RAS. Thus, metabolic and blood pressure control by RAS inhibition is to prevent or limit the onset of retinopathy and its progression towards visual-threatening stages.
The aim of the study is to categorise and analyse grading of DR who are on currently ACE and ARBs unchanged for at least 2 years.
MATERIALS AND METHODS
178 patients with type 1 and 2 DM of both genders on ARBs and ACEI unchanged for at least 2 years are divided into two groups as follows-
1. ARB group, which includes-
a) 28 patients on losartan (50 mg).
b) 32 patients on losartan (50 mg) + hydrochlorothiazide (12.5 mg).
c) 28 patients on telmisartan (40 mg).
d) 32 patients on telmisartan (40 mg) + hydrochlorothiazide (12.5 mg).
2. ACE inhibitor group includes-
a) 30 patients on enalapril (5 mg).
b) 28 patients on ramipril (2.5 mg) + hydrochlorothiazide (12.5 mg).
Retinopathy grading assessed by indirect ophthalmoscope and comparison of retinopathy grading between ARBs and ACEI groups have done. Two-tailed Chi-square test, GraphPad Prism Software used for statistical calculations.
RESULTS
Losartan and telmisartan (ARB group) showed significant protection from diabetic retinopathy than enalapril and ramipril (ACEI group) (p<0.05).
CONCLUSION
ARBs help in preventing the progression of DR and vision loss in those belonging to mild and moderate nonproliferative diabetic retinopathy patients.
